The Efficacy of Intravenous Amiodarone for the Conversion of Chronic Atrial Fibrillation

Kerin, Nicholas Z.

doi:10.1001/archinte.1996.00440010061008

Cited by 63 publications

(5 citation statements)

References 21 publications

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“…73 Conversion of chronic AF (lasting Ͼ3 weeks) was evaluated in a 32-patient randomized study. 74 There was no significant difference between intravenous amiodarone and oral quinidine in 24-hour conversion rates or control of ventricular response.…”

Section: Amiodarone For Afmentioning

confidence: 82%

Evidence-Based Analysis of Amiodarone Efficacy and Safety

1999

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Section: Amiodarone For Afmentioning

confidence: 82%

Evidence-Based Analysis of Amiodarone Efficacy and Safety

1999

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“…In the other studies on pharmacological cardioversion using quinidine 2–5,7–10 that are cited in the present guidelines, 1 relevant parameters associated with the risk of proarrhythmia such as plasma potassium levels, 2–5,7,9 QT interval duration, 2,5,9 and LVEF 2,3,5,9 were also not reported. In addition, the only concomitant medication that was allowed with quinidine therapy was digitalis 2,4,7–10 . Only in few patients, additional verapamil 3,5 or beta‐blockers were used 5 .…”

Section: Discussionmentioning

confidence: 96%

“…Only in few patients, additional verapamil 3,5 or beta‐blockers were used 5 . Furthermore, as most of the literature cited was published in the prethrombolytic and thrombolytic era, patients in the early phase after coronary interventions or cardiac surgery (those with a high incidence of AFib) were not investigated in most of the trials 2–10 and were excluded in the meta‐analysis of Coplen et al 15 Even though quinidine dosage and treatment schedule are comparable, it is highly questionable whether the results derived from the studies above may be transferred to a modern cardiac patient population such as reported here, in which very strict inclusion and exclusion criteria were used during short‐term quinidine therapy and continuous monitoring.…”

Section: Discussionmentioning

confidence: 99%

“…Especially in patients with coronary artery disease, quinidine is considered as a third‐line treatment choice because of a greater potential for adverse drug reactions (ADR) 1 . These recommendations, however, are based on a few studies of the early‐to‐mid 1990s, investigating only a small cohort of patients undergoing pharmacological cardioversion with quinidine 2–10 …”

mentioning

confidence: 99%

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Quinidine for Pharmacological Cardioversion of Atrial Fibrillation: A Retrospective Analysis in 501 Consecutive Patients

Schwaab¹,

Katalinic²,

Böge³

et al. 2009

Noninvasive Electrocardiol

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Background:Although quinidine has been used to terminate atrial fibrillation (AFib) for a long time, it has been recently classified to be used as a third-line-drug for cardioversion. However, these recommendations are based on a few small studies, and there are no data available of a larger modern patient population undergoing pharmacological cardioversion of AFib. Therefore, we evaluated the safety of quinidine for cardioversion of paroxysmal AFib in patients after cardiac surgery and coronary intervention.Methods: In 501 consecutive patients (66 ± 9 years, 32% women), 200-400 mg of quinidine were administered every 6 hours until cardioversion or for a maximum of 48 hours. Patients were included with QT interval ≤450 ms, ejection fraction (EF) ≥35%, and plasma potassium >4.3 mEq/L. Exclusion criteria were: unstable angina, myocardial infarction <3 months, and advanced congestive heart failure. Patients received verapamil, beta-blockers, or digitalis to slow down ventricular rate <100 bpm.Results: Quinidine therapy did not have to be stopped due to adverse drug reactions (ADR), and no significant QTc interval prolongation (Bazett and Fridericia correction) and no life-threatening ventricular arrhythmia occurred. Mean quinidine dose was 617 ± 520 mg and 92% of the patients received verapamil or beta-blocker to decrease ventricular rate. Cardioversion was successful in 84% of patients. All ADRs were minor and transient. Multivariate analysis revealed female gender (OR 2.62, CI 1.61-4.26, P < 0.001) and EF 45-54% (OR 1.97, CI 1.15-3.36, P = 0.013) as independent risk factors for ADRs.Conclusions: Quinidine for pharmacological cardioversion of AFib is safe and well tolerated in this subset of patients.

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“…It has not been shown convincely to possess higher conversion rate than the comparison agents in several trials. [69][70][71][72][73] The Class III effect manifested in chronic treatment probably does not occur in acute intravenous administration.…”

Section: Amiodaronementioning

confidence: 99%

Treatment of Acute Atrial Fibrillation: Ventricular Rate Control and Restoration of Sinus Rhythm

Fung

Kam²

2000

Hong Kong j. emerg. med.

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Atrial fibrillation (AF) is a familiar arrhythmia seen in the emergency department and the general population. In the past it was treated in the majority of cases by controlling the ventricular rate, whether the AF is acute or chronic. However, ventricular rate control alone does not address the underlying problem and the patients still remain in AF, cardiac output and symptoms have not been optimally corrected. There is definite risk of thromboembolism. Restoration of sinus rhythm is the only way of resuming the normal conduction physiology of the heart and correcting these problems This article provides a review of the two major principles of rhythm treatment of acute AF: rate control and restoration of sinus rhythm. Transthoracic electrical cardioversion is the mainstay of treatment in haemodynamically unstable AF, whereas in stable AF, there is a choice between rate control and restoration of sinus rhythm, or they can be carried out in conjunction with each other.

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The Efficacy of Intravenous Amiodarone for the Conversion of Chronic Atrial Fibrillation

Cited by 63 publications

References 21 publications

Evidence-Based Analysis of Amiodarone Efficacy and Safety

Evidence-Based Analysis of Amiodarone Efficacy and Safety

Quinidine for Pharmacological Cardioversion of Atrial Fibrillation: A Retrospective Analysis in 501 Consecutive Patients

Treatment of Acute Atrial Fibrillation: Ventricular Rate Control and Restoration of Sinus Rhythm

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